Safety and Efficacy of Endoscopic Balloon Dilation for Treatment of Crohn’s Disease Strictures

Ferlitsch, Arnulf; Reinisch, Walter; Püspök, Andreas; Dejaco, Clemens; Schillinger, Martin; Schöfl, R; Pötzi, R; Gangl, Alfred; Vogelsang, H.

doi:10.1055/s-2006-924999

Cited by 96 publications

(83 citation statements)

References 12 publications

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“…In this study, patients without stenotic symptoms were included as subjects, and the maximum observation period after EBD was only 3 years. Therefore, the cumulative surgery-free rate was approximately 70% at 3 years, similar to the results of previous studies (17)(18)(19)(20)(21)(22)(23)(24)(25)32). The cumulative rate of surgery in CD reportedly ranges from 46% to 62% at 5 years and from 61% to 75% at 10 years.…”

Section: Discussionsupporting

confidence: 88%

“…EBD is an alternative to surgery in CD cases with intestinal stenosis. The use of EBD for the stenotic lesions of CD has been reported since the 1990s, with the procedure being conducted using an upper gastrointestinal endoscope or colonoscope mainly for the stenosis in the upper gastrointestinal tract, in the large intestine, or at the anastomotic site (17)(18)(19)(20)(21)(22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of perforation is reportedly 0-9%, and this complication accounts for 5-25% of all cases with serious complications (17)(18)(19)(20)(21)(22)(23)(24)(25)(27)(28)(29)(30)33). In this study, portal emphysema developed in one patient (34); this complication was apparently attributable to the excessive CO 2 gas insufflation at the time of scope insertion, in addition to a pre-existing tendency for intestinal gas retention.…”

Section: Discussionmentioning

confidence: 99%

“…Advancements in endoscopic techniques and drug therapy, especially biological products, have enabled endoscopic dilation to be applied for intestinal stenosis in patients with CD, followed by enhanced medical treatments and the postponement or even avoidance of surgery (17)(18)(19)(20)(21)(22)(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic balloon dilation for stenotic lesions in Crohn’s disease

Kanamori

Sugaya²,

Tominaga³

et al. 2017

Turk J Gastroenterol

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Background/Aims: Endoscopic balloon dilation (EBD) can serve as an alternative to surgery for intestinal stenosis associated with Crohn's disease (CD). However, there has been controversy regarding the efficacy and safety of EBD. Here we sought to determine the therapeutic efficacy and safety of EBD for intestinal stenosis in CD. Materials and Methods: Of 43 patients with CD accompanied by intestinal stenosis, 30 underwent EBD. These 30 patients were examined retrospectively in terms of the scope passage rate, surgery-free rate, and whether or not the observation of the distal intestinal tract influenced the therapeutic strategy. Results: The overall scope passage and surgery-free rates were 90.0% and 76.7%, respectively. There were no statistically significant differences in the site of the dilated intestinal tract among groups. Patients who had inflammation in the distal intestinal tract alone after EBD accounted for 56.7%. The rate of re-dilation was 46.7%, and time until re-dilation was 6.6±3.6 months. Conclusion: EBD was associated with favorable short-term and long-term outcomes and good safety. Observation of the distal intestinal tract influenced the decision-making process for therapeutic strategies. The results of this study suggest that EBD may allow the postponement or even avoidance of surgery, enabling not only intestinal dilation but also the evaluation of mucosal healing to be performed. Thus, EBD is considered to be an effective alternative treatment for intestinal stenotic lesions in patients with CD.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic balloon dilation for stenotic lesions in Crohn’s disease

Kanamori

Sugaya²,

Tominaga³

et al. 2017

Turk J Gastroenterol

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“…For some time, it has been possible to treat benign strictures of the upper gastrointestinal tract with endoscopic balloon dilatation. Over the past 20 years, this method has become increasingly used for symptomatic Crohn's strictures in the ileum or colon [5][6][7][8][9][10][11][12][13][14][15][16] . The available results indicate equal technical effectiveness of the endoscopic procedures when compared to surgical therapy.…”

Section: Introductionmentioning

confidence: 99%

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

Stienecker¹,

Gleichmann²,

Neumayer³

et al. 2009

WJG

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AIM:To examine the long-term results of endoscopic treatment in a prospective study conducted over a period of 10 years, 1997 to January 2007. METHODS:A total of 25 patients (20 female and five male: aged 18-75 years), with at least one symptom of stricture not passable with the standard colonoscope and with a confirmed scarred Crohn's stricture of the lower gastrointestinal tract, were included in the study. The main symptom was abdominal pain. The endoscopic balloon dilatation was performed with an 18 mm balloon under endoscopic and radiological control.

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A comparison of endoscopic and surgical treatment of strictures in patients with Crohn’s disease

Dubcenco

MacDonald

Feagan

2013

Cochrane Database of Systematic Reviews

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Safety and Efficacy of Endoscopic Balloon Dilation for Treatment of Crohn’s Disease Strictures

Abstract: Endoscopic balloon dilation is a safe and effective method that allows surgery to be avoided in approximately 75 % of patients with Crohn's-associated short intestinal strictures. However, recurrent symptoms frequently make it necessary to repeat the procedure.

Cited by 96 publications

References 12 publications

Endoscopic balloon dilation for stenotic lesions in Crohn’s disease

Endoscopic balloon dilation for stenotic lesions in Crohn’s disease

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

A comparison of endoscopic and surgical treatment of strictures in patients with Crohn’s disease

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